Most Relevant Information
Provider Data
| NPI Number: | 1003514456 |
| Provider Name: | SUMMER ELIZABETH LACKEY PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 0010-12966 |
Most Important Dates
| Enumeration Date: | 02/15/2023 |
| Last Updated: | 03/27/2023 |
Provider Practice Location
705 GAITHER RD
STATESVILLE
NC
286253450
Practice Location Phone/Fax
| Phone: | 7048711155 |
| Fax: | 7048722484 |
Provider Mailing Location
PO BOX 1845
STATESVILLE
NC
286871845
Provider Mailing Phone/Fax
| Phone: | 7048734277 |
| Fax: | 7049783549 |